KATHERINE MARY SIEDOR (NPI# 1285013458) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285013458 |
| Entity Type | Individual |
| Full Name | KATHERINE MARY SIEDOR |
| Credential | PA |
| Practice Address |
766 Walther Rd Suite 100 Lawrenceville GA 30046-8764 |
| Mailing Address |
3000 Mornington Dr Nw Atlanta GA 30327-1222 |
| Practice Telephone | 6783129100 |
| Mailing Telephone | 4042454409 |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2015-05-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
766 WALTHER RD SUITE 100 |
| City | LAWRENCEVILLE |
| State | GA |
| Zip Code | 30046-8764 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043206477 | Michael A. Lipsitt | Internal Medicine | 766 Walther Rd, Suite 100, Lawrenceville, GA 30046-8764 | 2005-09-21 |
| 1699166173 | Gladys Orwenyo | Nurse Practitioner | 766 Walther Rd, Suite 100, Lawrenceville, GA 30046-8764 | 2015-02-05 |
| 1851630925 | Tiffany Kay Lanford | Nurse Practitioner | 766 Walther Rd, Suite 100, Lawrenceville, GA 30046-8764 | 2013-02-08 |
| 1679818991 | Gwinnett Heart Specialists LLC | Internal Medicine | 766 Walther Rd, Suite 100, Lawrenceville, GA 30046-8764 | 2012-11-28 |
| 1356507115 | Ajaz L Chaudhry | Otolaryngology | 766 Walther Rd, Suite 300, Lawrenceville, GA 30046-8764 | 2008-07-31 |
| 1790948578 | Atlanta Gwinnett Obgyn Associates PC | Obstetrics & Gynecology | 766 Walther Rd, Suite 100, Lawrenceville, GA 30045-8726 | 2008-07-02 |
| 1619157989 | Atlanta Gwinnett Women's Specialists | Obstetrics & Gynecology | 766 Walther Rd, Suite 100, Lawrenceville, GA 30046-8765 | 2007-11-05 |
| 1427199546 | Marcus Ceri Sims | Internal Medicine | 766 Walther Rd, Suite 100, Lawrenceville, GA 30046-8764 | 2007-02-09 |
| 1366456964 | Gregory Todd Fountain | Obstetrics & Gynecology | 766 Walther Rd, Suite 100, Lawrenceville, GA 30046-8764 | 2006-07-28 |
| 1336107978 | Lemuel G Villanueva | Obstetrics & Gynecology | 766 Walther Rd, Suite 200, Lawrenceville, GA 30046-8765 | 2006-05-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063023174 | Alpha & Omega Hearing Centers | Hearing Instrument Specialist | Alpha & Omega Hearing Centers, 250 Langley Drive, Suite 1106, Lawrenceville, GA 30046 | 2020-08-12 |
| 1285259846 | Mesun Health Services, Inc | Clinical Nurse Specialist | 88 Johnson Rd Building # 1-b, Lawrenceville, GA 30046 | 2020-06-10 |
| 1215550264 | Mesun Health Services, Inc | Skilled Nursing Facility | 88 Johnson Rd. Building #2, Lawrenceville, GA 30046 | 2020-05-26 |
| 1306499785 | Bryan Acosta | Chiropractor | 471 Scenic Hwy South, Lawrenceville, GA 30046 | 2019-07-24 |
| 1205308616 | Belle Lumiere Cosmetics LLC | Dermatology | 753 Old Norcross Road, Lawrenceville, GA 30046 | 2018-12-24 |
| 1548730179 | Alexis Nicole Robinson | Nurse Anesthetist, Certified Registered | 1000 Medical Center Boulevard, Lawrenceville, GA 30046 | 2018-11-27 |
| 1679060388 | Christopher Puckett | Student in an Organized Health Care Education/Training Program | 665 Duluth Hwy Suite 501, Lawrenceville, GA 30046 | 2018-04-18 |
| 1457851255 | Advanced Urology Institute of Georgia | Urology | 501 Crown Point Way, Lawrenceville, GA 30046 | 2018-02-19 |
| 1013447044 | Pharmacy Investments of Lawrenceville, LLC | Pharmacy | 738 Old Norcross Road, Ste A, Lawrenceville, GA 30046 | 2017-06-13 |
| 1225577000 | Priority Housecalls LLC | Clinic/Center | 225 Scenic Hwy, Ste 200, Lawrenceville, GA 30046 | 2017-02-14 |
| Find all providers in zip 30046 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811531767 | Kaceyanne Lynn Cerankowski | Physician Assistant | 3131 Princeton Pike Bldg 4a, Lawrenceville, NJ 08648-2201 | 2019-11-04 |
| 1528579950 | Julia Vlada Shumkov | Physician Assistant | 3100 Princeton Pike Ste D, Lawrenceville, NJ 08648-2300 | 2017-10-12 |
| 1851631337 | Dave George | Physician Assistant | 1960 Riverside Parkway Ste#106, Lawrenceville, GA 30043 | 2013-02-21 |
| 1528375946 | Gillian Robinson | Physician Assistant | 900 Legacy Park Dr, Apt 2333, Lawrenceville, GA 30043-8715 | 2010-09-07 |
| 1376705996 | Jacqueline Anne Ritter | Physician Assistant | 123 Franklin Corner Rd Ste 216, Lawrenceville, NJ 08648 | 2008-06-25 |
| 1457439747 | Michelle R Shoultz | Physician Assistant | 545 Old Norcross Rd Ste 300, Lawrenceville, GA 30045-3390 | 2006-11-02 |
| 1326132408 | Michael Johnson | Physician Assistant | 289 Grayson Hwy Ste 2a, Lawrenceville, GA 30046-5726 | 2006-10-03 |
| 1689626657 | Nocollege A Pupuma | Physician Assistant | 1431 Riverside Pkwy, Suite B, Lawrenceville, GA 30043-5946 | 2006-05-17 |
| 1073576716 | Jennifer T. Herbstritt | Physician Assistant | 2500 Brunswick Pike, Suite 101a, Professional Healthcare Services of Lawrenceville, Lawrenceville, NJ 08648-4134 | 2006-04-11 |
| 1285260745 | Elizabeth Joy Elder Sandy | Physician Assistant | 595 Hurricane Shoals Rd Nw Ste 100, Lawrenceville, GA 30046-8762 | 2020-03-17 |
| Find all providers in LAWRENCEVILLE | ||||
| City | LAWRENCEVILLE |
| Zip Code | 30046 |
Please comment or provide details below to improve the information on KATHERINE MARY SIEDOR.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.